Transarterial chemoembolization (TACE) is a standard treatment for intermediate-stage hepatocellular carcinoma (HCC). In this review, we summarize recent updates on the use of TACE for HCC. TACE can be performed using two techniques; conventional TACE (cTACE) and drug-eluting beads using TACE (DEB-TACE). The anti-tumor effect of the two has been reported to be similar; however, DEB-TACE carries a higher risk of hepatic artery and biliary injuries and a relatively lower risk of post-procedural pain than cTACE. TACE can be used for early stage HCC if other curative treatments are not feasible or as a neoadjuvant treatment before liver transplantation. . TACE can also be considered for selected patients with limited portal vein thrombosis and preserved liver function. When deciding to repeat TACE, the ART (Assessment for Retreatment with TACE) score and ABCR (AFP, BCLC, Child-Pugh, and Response) score can guide the decision process, and TACE refractoriness needs to be considered. Studies on the combination therapy of TACE with other treatment modalities, such as local ablation, radiation therapy, or systemic therapy, have been actively conducted and are still ongoing. Recently, new prognostic models, including analysis of the neutrophil-lymphocyte ratio, radiomics, and deep learning, have been developed to help predict survival after TACE.

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To achieve the broad utilization of the full functionality of graphene (GR) in devices, a transfer method should be developed that can simplify the process without leaving residue of the insulating supporting layer on the surface of GR. Furthermore, stable GR doping without the use of an insulating polymer is required. Here, a new GR transfer method that uses a popular conducting polymer, poly(3,4‐ethylenedioxythiophene):poly(styrenesulfonate) (PEDOT:PSS), is reported as a new supporting layer for the transfer of GR films that are synthesized by chemical vapor deposition. The GR/PEDOT:PSS bilayer can be directly utilized without the removal process. Therefore, this transfer method simplifies the transfer process and solves the residue problem of conventional transfer methods. The stable doping of GR films is simultaneously achieved by using the PEDOT:PSS layer. The new GR/PEDOT:PSS hybrid electrodes are fully functional in polymer solar cells and polymer light‐emitting diodes, outperforming the conventionally transferred GR electrodes and indium tin oxide electrodes.

Background and Purpose-An effective stroke code system that can expedite rapid thrombolytic treatment requires effective notification/communication and an organized team approach. We developed a stroke code program based on the computerized physician order entry (CPOE) system and investigated whether implementation of this CPOE-based program is useful for reducing the time from arrival at emergency departments (ED) to evaluation steps and the initiation of thrombolytic treatment in various hospital settings. Methods-The CPOE-based program was implemented by 10 hospitals. Time intervals from arrival at the ED to blood tests, computed tomography scanning, and thrombolytic treatment during the 1-year period before and the 1-year period after the program implementation were compared. Results-Time intervals from ED arrival to evaluation steps were significantly reduced after implementation of the CPOE-based program. Times from ED arrival to CT scan, complete blood counts, and prothrombin time testing were reduced by 7.7 minutes, 5.6 minutes, and 26.8 minutes, respectively (PϽ0.001). The time from ED arrival to intravenous thrombolysis was reduced from 71.7Ϯ33.6 minutes to 56.6Ϯ26.9 minutes (PϽ0.001). The number of patients who were treated with thrombolysis increased from 3.4% (199/5798 patients) before the CPOE-based program to 5.8% (312/5405 patients) afterward (PϽ0.001). The CPOE implementation also improved the inverse relationship between onset-to-door time and door-to-needle time. Key Words: acute stroke Ⅲ computerized physician order entry Ⅲ stroke Ⅲ thrombolysis T he efficacy of intravenous (IV) tissue plasminogen activator in acute ischemic stroke is time-dependent. 1,2 However, a recent systemic review indicated that the average time from a patient's arrival at the emergency department (ED) to the initiation of thrombolytic treatment exceeded 60 minutes in most studies. 3 There have been several efforts to reduce in-hospital time delays, including reorganization of the ED, 4 use of point-of-care international normalized ratio testing, 5 and use of an acute stroke triage pathway. 6 Stroke code systems and stroke team activities based on care protocols may expedite rapid thrombolytic treatment. 4 However, operation of a stroke code system requires many resources, effective communication between staff members of various departments, and adequate monitoring with feedback to continually improve the system. One promising approach for an effective stroke code system is using computerized physician order entry (CPOE). CPOE is a process that physicians use to enter medical orders electronically. These medical orders are communicated over a computer network linked to a hospital information system with physicians, nurses, technicians, and other staff in various departments. 7 accurate and rapid medical order entry and enables relevant staff to access necessary information immediately. Because CPOE permits capture of time data for individual steps more easily and objectively, it is useful to monitor the program's e...

HAIC is a useful alternative treatment for advanced HCC and further prospective investigations are required.

Background and PurposeThe recently developed total cerebral small-vessel disease (CSVD) score might appropriately reflect the total burden or severity of CSVD. We investigated whether the total CSVD score is associated with long-term outcomes during follow-up in patients with acute ischemic stroke.MethodsIn total, 1,096 consecutive patients with acute ischemic stroke who underwent brain magnetic resonance imaging were enrolled. We calculated the total CSVD score for each patient after determining the burden of cerebral microbleeds (CMBs), high-grade white-matter hyperintensities (HWHs), high-grade perivascular spaces (HPVSs), and asymptomatic lacunar infarctions (ALIs). We recorded the date and cause of death for all of the patients using data from the Korean National Statistical Office. We compared the long-term mortality rate with the total CSVD score using Cox proportional-hazards models.ResultsCMBs were found in 26.8% of the subjects (294/1,096), HWHs in 16.4% (180/1,096), HPVSs in 19.3% (211/1,096), and ALIs in 38.0% (416/1,096). After adjusting for age, sex, and variables that were significant at p<0.1 in the univariate analysis, the total CSVD score was independently associated with long-term death from all causes [hazard ratio (HR)=1.18 per point, 95% confidence interval (CI)=1.07–1.30], ischemic stroke (HR=1.20 per point, 95% CI=1.01–1.42), and hemorrhagic stroke (HR=2.05 per point, 95% CI=1.30–3.22), but not with fatal cardiovascular events (HR=1.17 per point, 95% CI=0.82–1.67).ConclusionsThe total CSVD score is a potential imaging biomarker for predicting mortality during follow-up in patients with acute ischemic stroke.

MR imaging with an endovaginal coil revealed significant morphologic alterations of the urethra and supporting structures in patients with stress urinary incontinence.

Background/AimsTo investigate the predictive factors for complete response (CR) and recurrence after CR in patients with hepatocellular carcinoma (HCC) treated with transarterial chemoembolization (TACE).MethodsAmong 691 newly diagnosed HCC patients, 287 were treated with TACE as a first therapy. We analyzed the predictive factors for CR, recurrence after CR, and overall survival (OS).ResultsEighty-one patients (28.2%) achieved CR after TACE, and recurrence after CR was detected in 35 patients (43.2%). In multivariate analyses, tumor size (≤5 cm) and single nodularity were predictive factors for CR, with hazard ratios (HRs) of 0.35 (p=0.002) and 0.41 (p<0.001), respectively. Elevated serum α-fetoprotein (AFP) (>20 ng/mL) level and multinodularity exhibited significant relationships with recurrence after CR, with HRs of 2.220 (p=0.026) and 3.887 (p<0.001), respectively. Tumor size (>5 cm), multinodularity, elevated serum AFP (>20 ng/mL) level, Child-Turcotte-Pugh score (B and C), and portal vein thrombosis were significant factors for OS.ConclusionsIn patients treated with TACE as a first therapy, tumor size (≤5 cm) and single nodularity were predictive factors for CR, and multinodularity and elevated serum AFP (>20 ng/mL) levels were predictive factors for recurrence after CR. These factors were also significant for OS.